Evaluation of using GeneXpert MTB/RIF technology in rapid detection of pulmonary tuberculosis and rifampicin resistance in Ningxia

doi:10.3969/j.issn.1000-6621.2021.08.006

Abstract

Abstract:

Objective To evaluate the application effect of GeneXpert MTB/RIF (GeneXpert for short) technology in rapid detection of pulmonary tuberculosis (PTB) and drug-resistant PTB patients in Ningxia Hui Autonomous Region (Ningxia). Methods Medical records of active PTB patients in Ningxia in 2016 and 2018—2020 were derived from the Tuberculosis Management Information System, a subsystem of China Disease Control and Prevention Information System. Numbers and results of active PTB patients detected by GeneXpert in each city in each year were obtained. The changes of rapid diagnosis of PTB patients and discovery of rifampicin resistance in them before and after the application of GeneXpert detection technology were analyzed and evaluated. Results The percentage of using GeneXpert for detection (application rate) in 2016, 2018—2020 were 22.55% (537/2381), 69.65% (1641/2356), 87.36% (2004/2294) and 89.78% (1634/1820), respectively. The annual difference was statistically significant (χ²=2929.500, P=0.000). From 2018 to 2020, the average application rate was 81.59% (5279/6470), which was about four times of that in 2016 (22.55%, 537/2381). In 2016, the application rate of five cities in the region were as follows: 25.77% (158/613) in Yinchuan City, 23.53% (32/136) in Shizuishan City, 22.80% (140/614) in Wuzhong City, 18.62% (105/564) in Guyuan City, 22.47% (102/454) in Zhongwei City, while the average rates from 2018 to 2020 were: 89.29% (1776/1989) in Yinchuan, 84.47% (555/657) in Shizuishan, 79.44% (1163/1464) in Wuzhong, 70.01% (810/1157) in Guyuan, 81.05% (975/1203) in Zhongwei. There was statistical significance among cities (χ²=190.245, P=0.000). From 2018 to 2020, through GeneXpert detection, the etiological positive rate reached 57.51% (3721/6470), which was 1.6 times of that in 2016 (36.20%, 862/2381). The difference was statistically significant (χ²=359.543, P=0.000). Among patients with smear negative results, 583 cases were GeneXpert positive, accounting for 15.67% (583/3721) of all etiological positive cases. In 2016 and 2018 to 2020, 291 rifampicin resistance tuberculosis (RR-TB) patients were detected by GeneXpert, accounting for 97.32% (291/299) of all RR-TB patients, and 21.40% (64/299) of those RR-TB patients were found in smear negative patients. Conclusion GeneXpert detection technology has covered the whole Ninxia region. Application of GeneXpert has greatly improved the detection rate of patients, especially for smear negative and RR-TB patients.

Key words: Tuberculosis,pulmonary, Nucleic acid amplification techniques, Comparative study, Ningxia

LIU Jing, XIAO Hui-xia, TIAN Xiao-mei, WANG Fu-rui, TIAN Xu-sheng, WANG Xiao-ping, CHEN Min, LEI Juan, WANG Xiao-lin. Evaluation of using GeneXpert MTB/RIF technology in rapid detection of pulmonary tuberculosis and rifampicin resistance in Ningxia[J]. Chinese Journal of Antituberculosis, 2021, 43(8): 783-789. doi: 10.3969/j.issn.1000-6621.2021.08.006

Figures/Tables 8

References 13

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年份	进行GeneXpert检测的患者数(例)	错误 [例(百分率,%)]	系统中途停止无数据 [例(百分率,%)]	无效 [例(百分率,%)]	未得到检测结果合计 [例(百分率,%)]
2016	537	16(2.98)	0(0.00)	6(1.12)	22(4.10)
2018	1641	51(3.11)	1(0.06)	16(0.98)	68(4.14)
2019	2004	47(2.35)	1(0.05)	10(0.50)	58(2.89)
2020	1634	33(2.02)	1(0.06)	9(0.55)	43(2.63)
合计	5816	147(2.53)	3(0.05)	41(0.70)	191(3.28)

年份	病原学阳性			涂阴患者GeneXpert检测
年份	活动性肺结核患者数 (例)	病原学阳性数 (例)	病原学阳性率 (%)	涂阴GeneXpert阳性数 (例)	占病原学阳性的比例 (%)
2016	2381	862	36.20	0	0.00
2018	2356	1249	53.01	172	13.77
2019	2294	1321	57.59	229	17.34
2020	1820	1151	63.24	182	15.81
合计	8851	4583	51.78	583	12.72

地市年份	病原学阳性情况			涂阴患者GeneXpert检测情况
地市年份	活动性肺结核患者数 (例)	病原学阳性数 (例)	病原学阳性率 (%)	涂阴GeneXpert阳性数 (例)	占病原学阳性的比例 (%)
银川市
2016	613	268	43.72	0	0.00
2018—2020	1989	1184	59.53	251	21.20
石嘴山市
2016	136	71	52.21	0	0.00
2018—2020	657	416	63.32	42	10.10
吴忠市
2016	614	228	37.13	0	0.00
2018—2020	1464	837	57.17	110	13.14
固原市
2016	564	121	21.45	0	0.00
2018—2020	1157	550	47.54	95	17.27
中卫市
2016	454	174	38.33	0	0.00
2018—2020	1203	734	61.01	85	11.58

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